本文選題：痤瘡 + 光動(dòng)力療法��； 參考：《中國(guó)人民解放軍醫(yī)學(xué)院》2015年碩士論文

【摘要】：目的：通過(guò)對(duì)比光動(dòng)力療法(photodynamic therapy, PDT)聯(lián)合米諾環(huán)素和單用米諾環(huán)素治療中重度痤瘡的臨床療效及對(duì)患者生活質(zhì)量影響,探討PDT在痤瘡治療中的臨床價(jià)值,評(píng)價(jià)PDT治療痤瘡的安全性及有效性。方法：將門(mén)診收集的符合入選條件的78例中重度痤瘡患者隨機(jī)分為兩組,PDT聯(lián)合米諾環(huán)素治療組39例,米諾環(huán)素對(duì)照組39例。PDT聯(lián)合米諾環(huán)素治療組：配制5%5-氨基酮戊酸(5-aminolevulinic acid,5-ALA)凝膠,涂抹于皮損部位,保鮮膜封閉,避光封包1.5h,用LED光動(dòng)力治療儀紅光照射全臉,照射劑量(90-100)J/cm2,照光距離10cm,照光20min,每周照光1次,治療4次；同時(shí)口服鹽酸米諾環(huán)素膠囊(玫滿),100mg/次,2次/日,口服4周。米諾環(huán)素治療組：口服鹽酸米諾環(huán)素膠囊(玫滿),100mg/次,2次/日,口服4周。所有患者在治療前及開(kāi)始治療后第2、4、8周應(yīng)用痤瘡綜合分級(jí)系統(tǒng)(Global Acne Grading System, GAGS)和痤瘡特異性生活質(zhì)量調(diào)查表(Acne Quality of Life, Acne-QOL)進(jìn)行療效觀察和患者生活質(zhì)量評(píng)估。記錄患者治療過(guò)程中出現(xiàn)的不良反應(yīng)。結(jié)果：兩組患者年齡、男女比例、病程、GAGS評(píng)分和Acne-QOL評(píng)分等基線資料均無(wú)統(tǒng)計(jì)學(xué)差異。PDT聯(lián)合米諾環(huán)素治療組患者治療2周、4周及8周時(shí)GAGS評(píng)分均顯著低于米諾環(huán)素組,差異均有統(tǒng)計(jì)學(xué)意義(P均0.01)。PDT聯(lián)合米諾環(huán)素治療組患者治療第2、4、8周有效率分別為：29.7%、64.9%和94.6%；治療顯效率分別為：13.5%、40.5%和78.4%；米諾環(huán)素治療組患者治療第2、4、8周有效率分別為：26.3%、57.9%和89.5%；治療顯效率分別為：10.5%、26.3%和55.3%。治療后第2、4、8周PDT聯(lián)合米諾環(huán)素組皮損有效率高于米諾環(huán)素組,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；治療后第2、4周兩組皮損顯效率不同,但無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),治療第8周PDT聯(lián)合米諾環(huán)素組皮損顯效率(78.4%)顯著高于米諾環(huán)素組(55.3%),差異有統(tǒng)計(jì)學(xué)意義。Acne-QOL評(píng)分與GAGS評(píng)分呈顯著負(fù)相關(guān)(相關(guān)系數(shù)r=-0.741,P0.01),即痤瘡越嚴(yán)重,患者生活質(zhì)量越差。PDT聯(lián)合米諾環(huán)素組患者治療2周后生活質(zhì)量輕度下降,隨后生活質(zhì)量顯著提高,治療8周時(shí),PDT聯(lián)合米諾環(huán)素組患者Acne-QOL評(píng)分(81.5±18.1)高于米諾環(huán)素治療組(71.7±16.7),差異有統(tǒng)計(jì)學(xué)意義(P0.01),PDT治療能夠顯著提高患者生活質(zhì)量。PDT治療痤瘡,不良反應(yīng)主要表現(xiàn)為紅斑、灼熱、腫痛和瘙癢等,表現(xiàn)程度輕微,患者能夠耐受,PDT治療結(jié)束可很快自行消退,無(wú)后遺癥狀。結(jié)論：PDT聯(lián)合米諾環(huán)素、單用米諾環(huán)素治療中重度痤瘡均有顯著療效。PDT聯(lián)合米諾環(huán)素治療中重度痤瘡無(wú)明顯不良反應(yīng),患者耐受性好,安全性高；PDT聯(lián)合米諾環(huán)素治療痤瘡療效較單用米諾環(huán)素更好,能顯著提高患者治療顯效率。PDT聯(lián)合米諾環(huán)素治療后患者生活質(zhì)量有短暫降低,主要與照光后不適反應(yīng)有關(guān),患者長(zhǎng)期生活質(zhì)量高于單用米諾環(huán)素。
[Abstract]:Objective: to investigate the clinical value of (photodynamic therapy, combined with minocycline and minocycline alone in the treatment of moderate and severe acne. To evaluate the safety and efficacy of PDT in the treatment of acne. Methods: Seventy-eight patients with moderate and severe acne were randomly divided into two groups: control group (n = 39) and minocycline control group (n = 39): 5-aminolevulinic acidine 5-ALA gel was prepared. The skin was smeared on the lesion, the preservation film was closed, the envelope was sealed for 1.5 hours, the whole face was irradiated with red light of LED photodynamic therapy instrument. The irradiation dose was (90-100) J / cm ~ (2), the distance of irradiation was 10 cm, the irradiation time was 20 min, once a week, 4 times a week. Minocycline hydrochloride capsules (Meiman) were taken orally twice a day for 4 weeks. Minocycline treatment group: minocycline hydrochloride capsule (Meiman) 100 mg / d twice a day for 4 weeks. All patients were treated with the Global Acne grading system (Gags) and the Acne quality of Life (Acne-QOL) before and after treatment for 8 weeks. Adverse reactions during treatment were recorded. Results: there was no significant difference in baseline data such as age, sex ratio, course of disease, GAGS score and Acne-QOL score between the two groups. The GAGS scores in the PDT combined with minocycline group were significantly lower than those in the minocycline group at 2 weeks, 4 weeks and 8 weeks, respectively. The difference was statistically significant (P0.01). The effective rates of PDT combined with minocycline were 64.9% and 94.60.The effective rates of treatment were 40.5% and 78.4%, respectively, and the effective rates of minocycline treatment group were 57.9% and 89.50.5% in the 24th week of minocycline treatment, 57.9% and 89.5m in the group of minocycline treated with minocycline, respectively. The effective rate of treatment was 26.3% and 55.3%, respectively. The effective rate of skin lesion in PDT combined with minocycline group was higher than that in minocycline group at 8 weeks after treatment, but the difference was not statistically significant (P0.05). However, there was no statistical difference (P0.05). At the 8th week of treatment, the marked effective rate of skin lesions in the PDT combined with minocycline group (78.4%) was significantly higher than that in the minocycline group (55.3%). The difference was significantly negative correlation between the acne-QOL score and the GAGS score (r = 0.741P0.01). The worse the quality of life. PDT combined with minocycline group, 2 weeks after treatment, the quality of life decreased slightly, then the quality of life improved significantly. The Acne-QOL score of patients in PDT combined with minocycline group (81.5 鹵18.1) was significantly higher than that in minocycline group (71.7 鹵16.7) at 8 weeks after treatment. The difference was statistically significant (P0.01) that PDT treatment could significantly improve the quality of life of patients with acne. The main adverse reactions were erythema and burning heat. Swelling, pain and pruritus are mild, the patient can tolerate PDT treatment end can quickly self-regression, no sequelae. Conclusion the effect of minocycline combined with minocycline and minocycline alone in the treatment of moderate and severe acne is significant. PDT combined with minocycline has no significant adverse effects on moderate and severe acne patients with good tolerance and high safety. The curative effect of PDT combined with minocycline on acne was better than that of minocycline alone. The long-term quality of life of patients was higher than that of minocycline alone.
【學(xué)位授予單位】：中國(guó)人民解放軍醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R758.733

【參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 唐建武;朱逢春;;激光—血卟啉腫瘤光動(dòng)力學(xué)療法的生物醫(yī)學(xué)機(jī)制[J];大連醫(yī)學(xué)院學(xué)報(bào);1992年02期

2 于小兵;吳曉金;桑旭東;張汝琴;沈惠良;潘曉濤;嚴(yán)麗英;廖新茂;;對(duì)痤瘡患者生活質(zhì)量影響因素的分析[J];中國(guó)麻風(fēng)皮膚病雜志;2006年10期

3 孟斌,溫博貴,李冠武,沈忠英;腫瘤光動(dòng)力療法誘導(dǎo)細(xì)胞凋亡機(jī)制研究進(jìn)展[J];生理科學(xué)進(jìn)展;2002年03期

，

本文編號(hào)：2095744